Arthroscopic Osteochondral Autograft Transplantation (OAT) in Patients with Focal Osteochondral/Chondral Lesions of the Knee Mid-Term Clinical Outcome.

Abstract

Introduction: Articular cartilage has limited healing potential as it is a hypocellular and avascular structure, hence it is to manage articular cartilage defects. The arthroscopic osteochondral autograft transplantation procedure is minimally invasive and cosmetically acceptable procedure to manage cartilage defects.

Materials and methods: This is a prospective study extending from 2018 to 2023 done at Sports Injury Center, New Delhi involving 36 patients with focal full-thickness chondral/osteochondral defect, age <45 were included. Global Chondral change, Multi ligamentous injuries, varus or valgus malalignment, kissing lesion and defect > 20mm were excluded. The osteochondral lesion was debrided down till healthy cartilage margins, donor graft was harvested from the non-weight-bearing area of the MFC. Lysholm score was used to assess functional outcome.

Results: Median age 35 years (range 20 - 44 years). A total of 51% of the patients were aged between 31 and 40 years (n=18). Male to female ratio was 3.37:1. The median defect size was 8mm (range 7-10mm). There was a gradual improvement in knee-specific symptoms with time. There was a significant increase in Lysholm score with time (p<0.0001).

Conclusion: The OATS procedure is a reliable, reproducible method and its results are encouraging with early mid-term follow-up; however, a long-term follow-up study is required to ascertain the validation of OATS procedure for preventing degenerative arthritis in patients with osteochondral injuries of the knee.